Between 6th and 7th of August, Recife held a workshop to elaborate Pernambuco’s Integrated Plan to Confront the Feminization of AIDS and other Sexually Transmitted Diseases. The Articulation Pernambuco AIDS, National Network of People Living With HIV/AIDS, Women’s Forum of Pernambuco and the Feminist Network of Health participated in the activity. The workshop was coordinated by the Women’s Secretary of Pernambuco and had the support of many secretaries and coordinations from the state cities, such as Recife and Caruaru.

A revised version of the Integrated Plan to Confront the Feminization of AIDS and other Sexually Transmitted Diseases is available at the Brazilian Special Secretary of Policies for Women.

Over the years, the participation of the civil society on monitoring the international policies of AIDS has increased. The follow-up of the commitments agreed by the governments in 2001, in the United Nations, has been the main outstanding aspect out of this process. In this perspective, after the experience in Brazil, the UNGASS-AIDS Forums have already began in Africa, Asia and Latin America aiming to integrate international discussions to the local issues and to strength the policies of sexual and reproductive health in the “four corners of the world”.

Phase 2009-2010

Africa – Uganda was the first country to hold the III UNGASS-AIDS Forum, in Kampala, between the 4th and 5th of June. Thirty-six members of people living with HIV networks, NGOs and government ministries (Gender and Development and Health) were there to discuss strategies of advocacy for the monitoring of the government’s commitments to reduce the AIDS epidemic and to improve the public policies on sexual and reproductive rights.

The outcome was an advocacy plan to be implemented between July/2009 and August/2010, using lobby, communication and networking as tools. Besides, the project intends to develop a research in the country focusing on violence against women and on sexual, reproductive and health education.

The city of Cape Town was chosen to hold the III South Africa Forum, on June 8th and 9th. The meeting, in the house of MOSAIC (a NGO) had two days of intense discussions about health and sexual and reproductive rights, with the participation of 20 Health, Women, HIV/AIDS and GLB movement organizations. An advocacy plan was also drawn, pointing out some issues as cervical cancer, abortion and sterilization. The cold from the beginning of the winter in the country wasn’t enough to cool down the temperature of the discussions and working plans!

In Kenya, the III UNGASS-AIDS Forum took place in Nairobi, on the 7th and 8th of July, with the participation of 40 organizations. The goal to strengthen the monitoring of the public policies of sexual and reproductive health drove the coordination of the forum to invest in communication – the KBC TV prepared a program about the UNGASS Forum and a radio program entitled “Afya ya Usazi” about reproductive health. Members of Uganda’s project participated in the meeting to help with the process. The relation with the media has been fairly explored in the country as a support of the project actions.

Asia – The debates about the monitoring of the sexual and reproductive goals in Asia have advanced a lot. Thailand’s Government, in partnership with the Thailand NGO Coalition on AIDS (TNCA), held the XII National Seminar on Aids, between the 28th and 30th of March, in Bangkok and included in some of the sessions the UNGASS-AIDS theme. Symposiums, workshops, community spaces and campaign activities were some of the actions of the Seminar, which gathered approximately 850 NGOs. Many of the information were disseminated through communication channels.

One of the sessions was dedicated to present the study done in 2008 by the Thailand UNGASS-AIDS Forum and coordinated by the Raksthai Foundation. This study, incorporated to the Country Report sent to UNAIDS in 2008, focused on the vertical transmission (mother-to-child). From this study, the government informed it will do a deeper research for 2010.

In Indonesia, the II UNGASS-AIDS Forum took place in Jakarta, between the 28th and the 30th of May. These two days were very productive with the definition of important working strategies to the country, among them, the elaboration of the Country Report, to be sent to UNAIDS, in partnership with the National Commission of AIDS and the gathering of qualitative data to write a civil society report on women sexual and reproductive health.

The Indonesia UNGASS-AIDS Forum, coordinated by JOTHI, held in June/July meetings with the National Commission of AIDS aiming to monitor the country’s answer to de Declaration of Commitments signed in the High Level Meeting of UNGASS, in 2001, New York.

Latin America – The Latin American forums have begun at the end of July. Uruguay is the first country to discuss the monitoring of targets, making the III UNGASS Forum on the days 31st of July and 01st of August. Argentina, Brazil, Belize, Nicaragua and Peru are in the process of organization. In parallel, the state, municipal and regional Forums in Brazil are already happening – the state of Paraiba was the first, the event took place on August 6th.

On the way to expanding the network within the country, a new state wide UNGASS-AIDS Forum will gather on 23 July 2009, in Joao Pessoa, Paraiba. The Forum has invited fifty organizations to participate in the meeting. It is coordinated by the Paraiba AIDS Articulation with the objective of broadening knowledge on UNGASS and to stimulate monitoring and advocacy initiatives in the state level.

The Forum will be a capacity-building workshop that will introduce the issue of monitoring through using the United Nations General Assembly Special Session on AIDS as the basic instrument. Essentialy, the health care supply chain is municipal. Advocacy needs to go to the city level to cause practical and visible impacts.

With the presence of thirty-six people representing Uganda’s networks of people living with HIV, non-governmental organizations, and two government ministries (Gender and Development, and Health), the III UNGASS-AIDS Forum met for two days at the Nob View Hotel, in Kampala, on June 4th and 5th, to design advocacy strategies for monitoring the government’s commitment to dramatically reduce the incidence of HIV/AIDS while securing sexual and reproductive health and rights of women and girls.

III UNGASS-AIDS Forum Uganda, Ntinda, Kampala.

The opening remarks by Beatrice Were, Executive Director of UGANET—Uganda Network on Law Ethics and HIV/AIDS—were focused on the human rights of people living with HIV/AIDS. “UGANET, in existence for fifteen years, was created to fill in a vacuum at a time when the epidemic was treated as a medical issue alone”, highlighted Were. In addition, she hoped for a fruitful partnership with Gestos to set forth a movement able to produce a study and a strategy for action.

Gestos’ Executive Director, Alessandra Nilo, set the desired tone for the large picture. “The role of this project is not only to produce a research to send to UNAIDS, but to stimulate the AIDS and women’s movements to work together toward making their government accountable, therefore improving the AIDS response throughout the country.”

The first session of the Forum was devoted to the analysis of the report produced by UWONET—Uganda Women’s Network—, the research results of the first phase of the Monitoring Women’s Sexual and Reproductive Health project, based on the UNGASS-AIDS goals and commitment. The national coordinator of the I and II Uganda Forum, Carol Indembe, showed a bleak picture of the country situation: “Are we able to get prevention, care, social support for women? Our report brought out the reality that it is not so, particularly if you are a woman.” According to the former forum’s coordinator, the report also confirms that gender unbalance is the main driver for the epidemic in Uganda. “What is being done to overcome that when the women have to share the drugs they are entitled to with their husbands or children?” Cultural tradition makes this issue even more complex when those women say, for example, “what my husband says is what I say.”

Ms. Indembe addresses the Forum.

Another great problem, explained Indembe, is that women are still not financially independent. “Women walk in the clinic and you help them, but if they are not economically empowered they go back to their torturer husbands. The day this woman was able to buy her own clothes was the moment, she said, that she was liberated.”

The coordinator of UNYPA—Uganda Network of Youth Positive Attitude—Paddy Masembe, followed the program by sharing his experiences as the only civil society representative at the UNGASS-AIDS High Level Meeting in New York, June 2008. As part of the country delegation he witnessed the reality behind his country’s representation. “Three government delegates participated as member of the National Delegation but they were usually not present in the sessions, they only appeared in the end of the day.” Mr Mesambe, a 26 year old AIDS activist, reported that members of civil society were left out of the HLM because of political reasons. “I made to the meeting by using resources mobilized by Gestos, but I later discovered that there were resources in Uganda to fund my participation and I was denied that.”

Action Plan

The result of those two days of discussion was a strategic advocacy plan to be implemented in the next two months. By shear division of expert labour, the Forum’s participant will execute a set of activities to bring about awareness on sexual and reproductive health and rights in the country, including lobby, communication, and networking. Furthermore, there will be a research on the state of women’s SRH in Uganda, focusing on three areas: violence against women, sexual education and sexual and reproductive actions.

The UNGASS-AIDS Forum coalition will formally introduce itself to high ranks of government and the parliament. It will call attention to its monitoring tasks and will report on the government accountability toward the Declaration of Commitment to HIV/AIDS it signed in 2001. In a country with many economic and social difficulties as Uganda, “citizens or receivers of public services should be empowered to demand accountability” summarized Beatrice Were. But she also admitted that they are not able do it as a single organization. “It is very critical that there is collective responsibility and sharing of information, all the time.”

Hope is in the air

The coalition united around a set of goals that include negotiating with the private sector and the government in an open, sincere, professional (‘strictly health business’) way. The objective is to build bridges and establish a sustainable dialogue toward improving SRH in a path to achieving universal access to all who need it in Uganda, a most beautiful country, bountifully blessed by nature in all levels, that has been for too long scarred by political evil-doers. Times have politically and economically changed – despite the current global crisis. The prospect for establishing rational civil relations is as positive as ever was. This is an opportunity the UNGASS-AIDS Forum Uganda is about to take on.

Since 2001, Gestos – HIV+ Communication & Gender – follows the resolution of the United Nations General Assembly Special Session on AIDS – UNGASS-AIDS.

In 2003, during the National Meeting of AIDS’ NGOs (ENONG) in São Paulo, Gestos was ellected to be part of the UNAIDS Working Group of Brazil in the seat of Civil Society with a proposal of mobilization and monitoring of the UNGASS-AIDS Declaration of Commitment, signed by one hundred and eighty nine countries. The result of this work was the first Fórum UNGASS-AIDS, held in the same year, with the partnership with the NGO Forum of São Paulo. Since then, Brazilian civil society has been an international reference for monitoring UNGASS-AIDS (please see tables below), taking the issue to state and municipal levels in different parts of the country.

The UNGASS-AIDS Forum Brazil is coordinated by GAPA and Gestos.

There are scheduled for 2009 the state forums of Paraiba and Rio Grande do Sul.

Understanding the National UNGASS-AIDS Forums

Forum

Where and when

Demands

Achievements

I Forum UNGASS-AIDS Brazil

Recife/PE. September, 2003

• Present and discuss the Goals of the Commitment Declaration for HIV and AIDS signed in 2001, at the United Nations General Assembly Special Session.

• Production of a Political Letter of Civil Society – The Letter of Recife;
• Participation of civil society representatives at the UNGASS meeting in NY, 2003.

II Forum UNGASS-AIDS Brazil

Recife/PE. March, 2005

• Broaden the knowledge on UNGASS-Aids among the AIDS Movement;
• Raise civil society participation at the UNGASS process;
• Setting up of a WG UNGASS-Brazil.

• Production of a Case Study with the theme: Access to Treatment in Brazil – A Civil Society Perspective, with the following axis:Technological capacity, the performance of Civil Society, Access to treatment by women, Sex Workers, MSM, People deprived of liberty, IDUs and Transvestites and Transsexuals

III Forum UNGASS-AIDS Brazil

Curitiba/PR September, 2005

• Raise Brazilian civil society participation at the UNGASS-AIDS monitoring process;
• Discuss civil society’s contribution in the making of the Brazilian Government report and the preliminary presentation, of the Case Study “Access to Treatment”.

• Articulate civil society’s agenda for the official revision of UNGASS in 2006

• Publication of the Case Study, of which content was incorporated to the official Brazilian government report;
• Civil society participation at the UNGASS-AIDS – NY 2006

• Building of an advocacy agenda with the investigation theme: the Inclusion of Women’s Sexual and Reproductive Health Actions in the National AIDS Policy
• Composition by different research groups by theme and regions

• Report incorporated by the Brazilian Government in its Official Report to the United Nations Assembly held in June, 2008
• Civil society representatives in the Brazilian delegation

V Forum UNGASS-AIDS Brazil

São Paulo/SP. May 2008

• Evaluate the monitoring actions of UNGASS-AIDS developed by civil society in 2007
• Promote political incidence of the AIDS Movement, derived from the report produced on Sexual and Reproductive Health policies

• Building of an agenda to follow up the State Plans of Fighting the Feminization of HIV and AIDS
• Production of the São Paulo Letter with remarks on the Brazilian Country Report, which was sent to the National STD and AIDS Program

Understanding the Regional, State and City UNGASS-AIDS Forums

Forum

Where and when

Demands

Achievements

I Forum UNGASS-AIDS Maranhão State

São Luís/MA. 2004.

• Contribute to community answers facing the monitoring of UNGASS/AIDS Goals and strengthening the National AIDS Movement in the State

• Perception of a dramatic AIDS panorama in the State, with total chaos in Health and Educational Policies
• Need to involve more social actors in the process of fighting the epidemics and articulate a partnership with the University in order to broaden researches on the subject and build indicators to advance in the local monitoring

I Forum UNGASS-AIDS Pernambuco State

Recife/PE. December, 2005

• Broaden local knowledge on UNGASS-AIDS and discuss how the Declaration’s commitments may influence public policies on HIV/AIDS control at State end City level.

• Building of a work agenda with action directed at the setting up of the II Forum UNGASS/AIDS Pernambuco;
• Need to mobilize a greater number of policy makers in STD/HIV and AIDS
• Discussion and deepening about the relation between local and international policies

• Setting up of a reference WG to systematize and analyze the proposals related to STD/HIV and AIDS made at the conferences of Health, Women, Human Rights, and children and Adolescents

II Forum UNGASS-AIDS Maranhão State

São Luís/MA. 2005

• Strengthen community answers against STD/HIV and AIDS

• Building of monitoring indicators through most vulnerable groups

• Advance towards strengthening and politization of AIDS activism in Maranhão;
• Production of a more political diagnosis of the social political economic conjuncture in Maranhão that points out the epidemics impact in the State.

I Forum UNGASS-AIDS North and Northeast Regions

Recife/PE. February, 2006

• Raise knowledge of AIDS NGOs and PLWAs Leaderships in the regions on UNGASS-AIDS, TRIPS, international policies and their impact on national policies on AIDS epidemics control and prevention.

• Production of an Action Plan for 2006 and setting of the participants priorities related to the axis of UNGASS-AIDS.

II Forum UNGASS/AIDS Pernambuco State

Recife/PE. December, 2006

• Give continuity to the monitoring agenda of the Declaration of Commitment and broaden knowledge on UNGASS/AIDS in the State, under the perspective of following up the epidemics interiorization

• Strengthen civil society participation in Maranhão on the process of monitoring the Declaration of Commitments of UNGASS-AIDS
• Analysis of a political scenario in Maranhão (HDI – Epidemics – Public Policies/Epidemics)
• Discuss Civil Society participation in this process;
• Set up a group with several social segments to give continuity to Monitoring in MA

• Setting up of a permanent WG with representations from the capital and interior and a more organized Work Plan

I Forum UNGASS-AIDS São Paulo State

São Paulo/SP. May, 2008.

• Report under construction

• Building of na Action and Monitoring Plan. (Report under construction)

I Forum UNGASS-AIDS North Region

Belém/PA. September, 2008

• Evaluate UNGASS monitoring actions developed in the region for the past two years

• Plan UNGASS monitoring actions for the next two years;

• Building of a Monitoring Plan to monitor HIV/AIDS Public Policies in the region

I Forum UNGASS-AIDS Campinas/SP City

Campinas/SP. November, 2008

• Present the Declaration of Commitments to civil society and policy makers of the city

Report under construction

I Forum UNGASS/AIDS Acre State

Rio Branco/AC. March, 2009

• Discuss the importance of Implementing the AIDS Feminization Fighting Plan in Acre and the monitoring performed by Brazilian Civil Society

Report under construction

Sources: UNGASS-AIDS Forums Reports (Nationals, Regional, State and City); Case Study: ARV Treatment in Brazil: the Civil Society Perspective, and National Program on STD and AIDS.

There is a direct relationship between HIV/AIDS and violence affecting all social strata, be it through sexual exploitation or abuse – that many times have roots at home. “It is crucial to teach the girls how to defend themselves and to denounce the violence they are victim of,” says one of the participants of the workshop Girls United Against Violence and AIDS that reaches the counties of Recife and Cabo. The campaign, beyond the workshop, has a blog that is used by them to post their views on cases of violence reported by the media, or just to show their views on ways to comfort victims of peculiarly violent situations for being a girl.

The campaign, launched in 2007, has a pioneer approach when interfacing violence and AIDS. The actions include monitoring the system of the Children and Adolescent Rights Act – ECA –, the care structure for youth victim of violence, while reinforcing the need for preventing violence and the HIV/AIDS with youth victim of abuse and sexual exploitation through a sequence of “dialogue roundtables” on the issue at public schools.

Even though there are positive response, the Campaign identifies many challenges such as the lack of unified database system that would ease the monitoring of violent cases, that are badly monitored for the sheer lack of basic information entry. The health care professional resist to write down the cases in detail. And the worst case scenario, the lack or limited prophylaxis medication for HIV in cases of rape.

Between February 2007 and June 2008, Gestos, with support from the Ford Foundation, among other partners, acted upon to consolidate the formation of a network of sixteen countries, from Africa, Asia, Latin America and the Caribbean, and Eastern Europe, with the objective of monitoring and evaluating public policies of sexual and reproductive health and rights of women with HIV/AIDS.

There was a total of 433 groups and national advocacy networks of the Women’s, AIDS’ and Human Rights’ movements that acted politically on the issue, having as reference the monitoring of the Declaration of Commitment signed at UNGASS-AIDS 2001.

The results of the experience were systematized at Monitoring the UNGASS-AIDS Goals on Women’s Sexual and Reproductive Health comparative report, launched at the UNGASS-AIDS review meeting, June 2008, New York. The Comparative Report was sent officially to UNAIDS as a civil society shadow report. According to the then UNAIDS Executive Director, Dr Peter Piot, “this was the only document produced for UNGASS-AIDS that deals with critical questions to sexual and reproductive health of women living with HIV/AIDS or in a vulnerable situation.”

Ms Alessandra Nilo, Coordinator of the Political Pedagogical Program of Gestos, announced that, in the period of 2009–2011, besides articulating with the partners network to participate in the national processes of monitoring UNGASS-AIDS, the main strategy will be to design advocacy plans in each one of the countries aiming at including sexual and reproductive health as a priority axis in the National AIDS Plans. “The objective is to include the issue of the interface of sexual and reproductive health and AIDS in the political agendas in the countries participating in the project; in the moments of UN reviewing Universal Access, in the strategies of monitoring International Conference on Population and Development (ICPD+15) and the IV Women Conference (Beijing+15), as well as the next International AIDS Conference, to be held in Vienna in 2010.” Concludes her with what it seems her monitoring advocacy mantra.

Because of budget constraint, not all countries that participated in the first phase of the project will participate in the second phase. Raising funds in a time of economic crisis has become ever more difficult. In the new phases the countries where there will be UNGASS-AIDS Forum: Women’s Sexual and Reproductive Health are: Argentina, Brazil, Uruguai, Peru, Nicaragua, Belize, Indonesia, Ukraine, Thailand, South Africa, Kenya and Uganda.

Advocacy Network

Civil Society and UNGASS-AIDS

Gestos, Brazilian NGO located in Recife, has utilized the Declaration of Commitment from UNGASS-AIDS 2001 as an instrument for advocacy and research of sexual and reproductive health of women and girls in public policies of sixteen countries. The project is funded by the Ford Foundation, with support from UNAIDS and the Center for International Technical Cooperation—CICT—of the Brazilian National AIDS Program.